Moving on….Starting on insulin....positive signs of improvement ...glimmers of hope...

[Molly56]

Just thought today would be a good day to take stock of where we are…..

It is still over three weeks until his first appointment with the community diabetic team to discuss the next step of going on to insulin…..this will be almost three months since the review where the diabetic nurse at the GP practice told him that this is what is needed and made the referral…

As an interim measure the nurse saw him last week to see how he is doing ….at this appointment she reaffirmed that he does need to keep daily blood glucose readings to take to this appointment so that they can see what his levels are and decide on insulin regime……to this end I have created and printed off a chart and we now have readings for the last couple of days…..

Morning readings (am/fasting) were 10.3 and 11.4; afternoon readings (pm /before dinner) were 21.4 and 16.6; evening readings (before bed) were 18.7 and 16.6….

….these readings are all high I know and not ones that people will feel comfortable with….but it does demonstrate that things are not working as they are and that the need for insulin to bring these levels down is required….

Just to say at this point that I do fully understand how and why people test before and after they eat etc but this is not the point of this particular exercise….the point here is firstly to get him to test (he has always been reluctant to do so) but more importantly to provide the information required for the medical staff in terms of determining a pattern of levels if any....

The other point here is that he has got to a point where this is currently the only option (I know people may well disagree with this comment)…..after fifteen plus years (don’t know how many as was not with him then) of being a type 2 diabetic and not being in control….this is where he is at….
…..no amount of diet or exercise will change the fact that his body is no longer working to deal with the blood sugar levels…..complications are setting in and this is what we now have to deal with…
…..perhaps it would have been different if he had taken more notice of his diabetes in the past but he didn’t .....and nothing can change that fact….

To add to all of this, as if this isn’t enough, he has now received a date for a minor surgical procedure …..within the next couple of weeks….whether this will go ahead or not based on the current status of his diabetic control (something I believe was mentioned at the consultation but I wasn’t there) will be down to the medical staff to decide…

….personally if I were him I would not be considering this as an option at the moment given the risks of infection and poor healing in a diabetic but I am not him and ultimately this must be his decision …..and that of the medical professionals….he sees no reason why this will not go ahead but we will have to wait and see…

He did have a blood test this week for HbA1c and for kidney function tests (in preparation for insulin appointment) so at least these details should show up on his hospital records…..will not get the results of these until we go for the appointment in February as doubt very much he will contact them for results beforehand…..am guessing if anything shows up as being URGENT he will be contacted in the meantime….

Perhaps this all now explains why I am feeling like that swan……trying to maintain a calm composure on the outside but paddling like hell beneath the surface….

….time now to get on with the rest of my day…..

 

[Scouser58]

Afternoon Molly, wow this post is really on the bottom line, and what a bottom line it is... your swan will wear out it legs before long at that paddling rate...your post sounds really flat and you must be so tired of trying to be motivational to a 'man who will not listen'... the results will determine so many things, and operations with such high readings are very scary..

Molly how do you feel like giving him so more tough care...you mentioned healing and problems, have you mentioned the Retinopathy. and the problems that declining sight can bring... Just watching Patch Adams and the doctors talking over a patient with bad diabetic problems, and mentioned amputation..she looked very frightened...will anything scare him indoors???...

Molly if I could give you a medal for care, then I would....are you having a nice roast dinner to day??? you could do him more meat and veg to help a bit, but he would miss the roasties too much?....

I think when he realised that you are worried about his diabetes, and you took up researching it, he just could not be bothered, and let you take it on board,....typical male not worried, unless it starts stopping what he wants to do, even though what he is doing is totally wrong...has he got his life and affairs in order?....and will you let his children know where things are up to?....

Molly you need a rest, and a chat with a good friend, when are you meeting up with your friends soon, Molly time is now urgently needed...always here for you Molly, ttfn Karen

 

[Molly56]

@Scouser58 ...thanks for the message.......am finding some time for myself at the moment.....is plenty else going on in terms of more appointment dates etc but am just pencilling those in the diary and will deal with them as they arise...

Went out today for a bit of retail therapy.....decided I needed a plant for my sewing room.....for any horticulturists out there (@donnellysdogs ) the plant I ended up choosing ....(or it sort of chose me).....was a spathiphyllum (to give it it's latin name)......or giving it it's common name, the "Peace Lily"........somehow thought this was particularly appropriate under the circumstances ....
Plants are always good in my book as they need caring for but give a lot back in terms of pleasure....and are very therapeutic too...

Am trying to remain swan-like wherever possible....

 

[Scouser58]

Hi Molly, the "Peace Lily", did you know that one of these plants was featured in the humorous film, "Hot Fuzz", Simon Pegg was the efficient copper,who got transferred to a small 'Town' which was rife with crime, any way when he found 'peace' the lily flowered beautifully on his desk, motto here be happy with yourself, and only work on things that are needed to be worked on at a time, inner peace is vital to the human soul.....

On a site called @pintrest weekly there are lots of pictures of animals, the cuteness is sky high, there is one of a Beluga Whale, all white and smiling, give it a look it always makes me smile,....many pictures of Maltese dogs, some teacup size, have a look and have a
'smile time' they send pictures once a week.....

The Peace Lily found you, well it knew you needed the therapy and the joy that peace in work, home and all things bothering you...including him indoors, the other plant I like is Amaryllis, when planted the bulb grows really fast everyday they are taller, and when it flowers, they are so big and they make me feel happy and they last for days, then the leaves grow to feed the bulb......

Molly how about giving the swan's legs and webs a rest, and glide along on the current of tranquillity and let the swan, rest it's head back onto it's back and have a restful snooze, without watching the ducks bobbing about!....then when rested, fluff up your feathers and have a little preen, hair do, manicure etc, and then go back to gliding along on the gentle flow of life,

Molly maybe if you 'ignore' what him indoors is doing/not going, your gliding will be so peaceful and you will be 'glowing' with restfulness ....always here for you, Karen

 

[donnellysdogs]

Love peace lilies Molly. Didn't realise the details which scouser gave. To me its a plant of elegance as well. The flowers are delicate and beautifully plain but hidden beauty. To them.
Unlike my xmas cactus which has pink vibrant, luxurious, exotically frilly flowers. (None of which describe anything towards my personality at all!-lol) ...will also have to look at getting a peace lily!!
Used to like the mother in laws tongue too!!

Will catch up later Molly and Scouser.. Busy day today. Do think though Molly that Scouser is right with the gliding along... I'm sure theres a little pond somewhere to do this...

 

[Ruth B]

We have a peace lily in the office, and it never looks particularly healthy, not sure if this is a reflection of the office politics or the fact that watering is eratic, feeding non existant and it was left over Christmas and New Year with no heating.
At home I have a Christmas cactus that has just finished flowering, brilliant red flowers and my new favourites are Butterworts, small rosettes of leaves and blue/purple flowers on long stems. They are also carnivorous and the leaves are slightly sticky so help keep down those annoying tiny flies in the spring and summer. Got some out door butterworts as well in a container with some pitcher plants, I'm having a bit of a war on insects in my garden.

 

[Molly56]

@Scouser58 ...thanks for the message.......am finding some time for myself at the moment.....is plenty else going on in terms of more appointment dates etc but am just pencilling those in the diary and will deal with them as they arise...

Went out today for a bit of retail therapy.....decided I needed a plant for my sewing room.....for any horticulturists out there (@donnellysdogs ) the plant I ended up choosing ....(or it sort of chose me).....was a spathiphyllum (to give it it's latin name)......or giving it it's common name, the "Peace Lily"........somehow thought this was particularly appropriate under the circumstances ....
Plants are always good in my book as they need caring for but give a lot back in terms of pleasure....and are very therapeutic too...

Am trying to remain swan-like wherever possible....

@Scouser58 @donnellysdogs
Have just been thinking about my shopping trip yesterday and my purchases…..other than the Peace Lily mentioned in my previous post was just thinking about the other items….other than some socks and a new laundry bin the only other things I purchased were a couple of books…..

Other than plants, books are my other great weakness and am always one for the bargain book shops…..yesterday was no exception and found two books …..the first was a sewing book so fits well with my new enthusiasm for being creative….the second I think says much more than at face value..

For some reason I was drawn to this book …..perhaps it was the bargain price of just 10p….or perhaps in hindsight it was more than that….
….the title of the book is “If you’ve raised kids, you can manage anything”….

….the purpose I think of the book is to demonstrate to women their value in the workplace and to show that management skills acquired through managing a home (and kids) can be transferable skills to the world of business….useful tips I am sure….

….however I do just wonder if this is the reason that I bought it or if it says more about my situation here and how I am feeling at the moment…..it will be interesting to read and find out….

I can always read and paddle at the same time....

 

[Scouser58]

Hello Molly, donnellydogs and Ruth B, yes Ruth the peace lily needs tlc, so put it on a desk, with a little feed and feed after watering, and be positive in attitude when near it.

Donnellydogs, I have a Christmas Cactus in Pink, it flowered before Christmas, and I have to prop up the stems with wooden sticks, but while it flowered it was nice, the colour is the one that caught your eye when you bought it, so your soul loved pink, nowt wrong with that.

Molly your books sound interesting and could well be a great help, the sewing book could have some great things for you, have you looked on Hobbycraft site, they have all sorts for the nimble of fingers, and Abakhan fabrics have loads of stuff for the creative ones, worth a look.....

Your other book about "If you've raised kids, you can manage anything" for 10p could well be very enlightening....but raising kids in my generation is totally different today's ways...... the old ways are the better ones, in my opinion that is....no answering back, no swearing, no tantrums, and doing as you were told.... not much of any of these can be seen about now a days....

As for buying ...Socks, not inspiring, Molly and the laundry basket, tut tut.......while I have been typing this I thought it was Sunday, my brain cell had a wobble.or was it a wibble wobble, or what ever......

Well it now Wednesday, I think? and another week is rushing past, life is so much fun, don't you think? To you I wish a good night, as always here for you , from Karen

 

[Molly56]

Another week on and another week closer to the appointment for insulin…..just over two weeks now….

The last week has seen a number of developments……blood sugar readings are now being taken on a daily basis with two or three readings per day (bedtime one sometimes forgotten)….generally around the 11.6 mark in the morning with readings around 16 before dinner and 13 before bed….at least this will give them something to go on when deciding which insulin regime to put him on…

An appointment for a pre op assessment resulted in the procedure being postponed for the foreseeable future ……this was due to his diabetes and the high levels of HbA1c……evidently his latest HbA1c (from blood test last week) showed up as over 90 on their screens…..this has risen from 74 back in November so further indicates that the current medication is not working to bring his levels down…
…..this hopefully will be the incentive that he needs to work with the diabetic team to bring his levels down to a point where he is deemed fit for the procedure…

This is what I thought (and secretly hoped) would happen but there was no point me trying to tell him this……it took a medical professional to sit him down and tell him this and explain why they would not consider him at this time….with the risks of a general anaesthetic and resulting healing / possibility of infection I am somewhat relieved that this is the path they chose to follow and at least now he knows he has to take control of his diabetes if he wants this particular procedure to go ahead….

Other positive points that I have noticed this week are that when out shopping together he was taking notice of the labels on food and in particular the amount of carbohydrates in foods…..finally my message is getting across….he did still choose to buy bread but selected the one with the lowest carbs per slice…..so some progress here…

Hoping that the next week finds more positive news but at least the stresses of the past couple of weeks are reducing slightly....(I was really worried about the operation)...…..and hopefully a more positive approach to dealing with this is emerging….

 

[AndBreathe]

Another week on and another week closer to the appointment for insulin…..just over two weeks now….

The last week has seen a number of developments……blood sugar readings are now being taken on a daily basis with two or three readings per day (bedtime one sometimes forgotten)….generally around the 11.6 mark in the morning with readings around 16 before dinner and 13 before bed….at least this will give them something to go on when deciding which insulin regime to put him on…

An appointment for a pre op assessment resulted in the procedure being postponed for the foreseeable future ……this was due to his diabetes and the high levels of HbA1c……evidently his latest HbA1c (from blood test last week) showed up as over 90 on their screens…..this has risen from 74 back in November so further indicates that the current medication is not working to bring his levels down…
…..this hopefully will be the incentive that he needs to work with the diabetic team to bring his levels down to a point where he is deemed fit for the procedure…

This is what I thought (and secretly hoped) would happen but there was no point me trying to tell him this……it took a medical professional to sit him down and tell him this and explain why they would not consider him at this time….with the risks of a general anaesthetic and resulting healing / possibility of infection I am somewhat relieved that this is the path they chose to follow and at least now he knows he has to take control of his diabetes if he wants this particular procedure to go ahead….

Other positive points that I have noticed this week are that when out shopping together he was taking notice of the labels on food and in particular the amount of carbohydrates in foods…..finally my message is getting across….he did still choose to buy bread but selected the one with the lowest carbs per slice…..so some progress here…

Hoping that the next week finds more positive news but at least the stresses of the past couple of weeks are reducing slightly....(I was really worried about the operation)...…..and hopefully a more positive approach to dealing with this is emerging….

Molly, I have only one comment to make, but I feel it too important to pass on by.

You say, ".....so further indicates that the current medication is not working to bring his levels down…......"

That's a bit like saying I don't like the elastoplast my medics recommend I use when I cut myself isn't looking after the quality of my skin, and expecting them to change it, when actually the answer is for me to stop playing with sharp implements.

OK, not a perfect anology, but just to reiterate that for diabetics, the most important, powerful and critical tool we have in fighting diabetes is every morsel that goes in our mouths. If we are eating fewer carbs, our bloods will not rise as far, and the meds have half a chance of keeping his bloods in range. Observationally, it almost looks to me like each time his meds have been increased he has seen that as a green light to up the naughties; because "the meds are designed to deal with them".

Discussions with medical professionals are periodic at best, more likely one offs, whereas you have the opportunity to have calm and balanced discussions with him any time and as often as would seem appropriate. Most difficult messages need reinforcing. Most of us can forget messages delivered in medical appointments; I know I can. Some can even blank the messages out like they were never delivered.

Aristotle commented on the role of repetition in learning by saying “it is frequent repetition that produces a natural tendency” (Ross & Aristotle, 1906, p. 113) and “the more frequently two things are experienced together, the more likely it will be that the experience or recall of one will stimulate the recall of the other” (p. 35).



Link removed as not relevant. CC

 

[Scouser58]

Afternoon Molly, well the hospital bods did their bit and told him in the strictest way they could, no op until the bloods go down, and I hope you feel more relieved at the instructions now being stuck to...

Molly him in doors might work harder at the monitoring thing and could even get the levels down, even to the point were the insulin 'threat' may be removed,...a neighbour of mine got put onto insulin and I heard she was really upset at the out come,....I think she is very sedentary and as we all know movement helps with the levels, and she does look very slow when ever I see her out of doors.

Every label helps, to nick a phrase-ish.....I have a bagel, lightly toasted with original Philly cheese on for my breakfast and it seems to 'fill me up' just nicely, that's it when the dog lets me have enough!?...
So from this time forward is the moderation of the eating going to get to new heights of co-operation? and is he going to stop going to the cafe for his breakfast?

Molly may this week go along at a new found level of calmness, and you feel more rested, as always Molly here for you from Karen

 

[Molly56]

It is now just under a week until he has his appointment with the community diabetic team about moving on to insulin......it seems like we have been waiting forever for this appointment and eventually it is nearly here.....
Not sure quite how I am feeling about this all at the moment.....have been through so many thoughts in my head as to how this will actually work out in practice .....is all very well in theory and on paper but in practice, well that is a totally different matter.....
I guess all I can hope for at this stage is that when he gets to the appointment next Wednesday he is in the frame of mind to listen to what they have to say and is accepting of what insulin regime they decide to start him on.....I do have some concerns as to whether this is the case or not but hope that it will be a positive start to this next stage in his diabetes journey....

 

[Molly56]

It is now just under a week until he has his appointment with the community diabetic team about moving on to insulin......it seems like we have been waiting forever for this appointment and eventually it is nearly here.....
Not sure quite how I am feeling about this all at the moment.....have been through so many thoughts in my head as to how this will actually work out in practice .....is all very well in theory and on paper but in practice, well that is a totally different matter.....
I guess all I can hope for at this stage is that when he gets to the appointment next Wednesday he is in the frame of mind to listen to what they have to say and is accepting of what insulin regime they decide to start him on.....I do have some concerns as to whether this is the case or not but hope that it will be a positive start to this next stage in his diabetes journey....

Just to update on my last message.....it is going to be a nightmare.......
....he has just said he will be glad when he goes on the insulin ......so that he can stop testing his blood sugar every day.....
......my stress levels are going up....

 

[Scouser58]

Hello Molly,missed you here......I long awaited appointment is nearly here and 'pre-date nerves' are showing up.....I understand your apprehension and pondering's about what can happen.....well from what I know about using insulin, there protocols are set to make the insulin use beneficial to the patient........ Pre meals injection(s), and the timing of meals following it.... also the food intake.... needing to be monitored to maintain the balance......insulin is not something that can be treated with indifference.....Molly you have gone so far to get 'him in doors' to this point of treatment and yes, you are 'in two minds' about what can/could happen next.

Well now you can now sit and watch the actions, and 'try' to stay calm and 'unstressed'......this could be very difficult for you......but you must keep calm.......The people who see him next week will stress on him the importance of keeping the 'plan' on track and not ignoring the need to take the insulin at the correct times, and correct doses and the having a meal.......

Molly please don't become 'worried about what is happening' while you are at work, or out and about..... and be calm while he gets use to the injecting in the thigh or stomach muscles.......
You are now at the sit and watch point, you have done so much, now it is all up to him....... you just need to watch, listen, and ask questions and read stuff, than wait and watch.......
Molly I am here for you as always, at any time from Karen

 

[Totto]

Just to update on my last message.....it is going to be a nightmare.......
....he has just said he will be glad when he goes on the insulin ......so that he can stop testing his blood sugar every day.....
......my stress levels are going up....

What did you reply to him?

A suitable response would have been ARE YOU COMPLETELY OUT OF YOUR MIND? IT IS COMPLETELY THE OTHER WAY AROUND.
I do hope you shouted very loud.

 

[AndBreathe]

Just to update on my last message.....it is going to be a nightmare.......
....he has just said he will be glad when he goes on the insulin ......so that he can stop testing his blood sugar every day.....
......my stress levels are going up....

Molly - Have you ever asked him what he thinks it will be like when he's on insulin, and ask him to describe what a "normal" day will be like for him?

That might give you an insight into some of the challenges you might face, but also might help with some discussion points during his appointment, so that the HCPs can explain to him how it needs to be.

Does he understand how many people newly taking insulin end up gaining weight, due to the tricky nature of getting the balancing act right? It strikes me that would all be exceedingly unhelpful, bearing in mind he has knee, hip and general joint pains. It could also be unhelpful on his route to the op he has had postponed.

When he realises what a bind insulin really is, he may take an interest in what he needs to do to get off it. At the moment, in my view, he sees insulin as the route to an easy life, where he can do, and eat and drink, exactly as he pleases as the insulin will take care of it all.

He really is at the Shape Up or Ship Out crossroads and I reckon I know which route he'll choose. I really do hope you can come back and rub my nose in that.

 

[Molly56]

What did you reply to him?

A suitable response would have been ARE YOU COMPLETELY OUT OF YOUR MIND? IT IS COMPLETELY THE OTHER WAY AROUND.
I do hope you shouted very loud.

@Totto.... I did try to correct him and asked the question about how he would know how much insulin he needed if he didn't test .......but he doesn't listen to what I say.....which has been part of the problem all along...

Anyway, as I see it the important thing for me to do at this point in time is to make sure that he keeps that appointment next week.....and then as @Scouser58 says .....it will then be down to them to explain to him how it is going to work and what he needs to do........after that I can reinforce the message or in not so many words say "I told you so...."

The danger I feel at the moment would be that he somehow manages to cancel that appointment or refuse to attend the appointment....

@AndBreathe ....for the reasons stated above I have not asked him the questions that you suggest....though they are valid questions and ones that I have thought about....

As you rightly say "the HCPs can explain to him how it needs to be..."

..I am acutely aware of the challenges that I will face which is why I am so concerned about this move....and these will be points that I plan to raise at the appointment with a number of "what if" scenarios......his 'normal day' does not follow the conventional pattern of most other individuals in terms of sleeping / eating etc which is where I can see many problems arising in terms of moving on to an insulin regime...

..rightly or wrongly, putting him on the spot in front of someone else is I fear the only way of making him face up to this and hopefully coming to a workable solution...

Quite frankly he doesn't have a clue about this....hence his earlier comments ....and I certainly don't think he has thought of it as the route to an easy life......in fact he gives it no thought at all........he just doesn't see his diabetes to be a problem and, as my GP said to me at an appointment the other day, he is clearly suffering from "head in sand" syndrome....

I think we both know which route he is going down....they say miracles do happen......but I doubt it....

 

[Scouser58]

Hi again Molly, just seen your extra bit of the message I read, oh Molly what a shock to hear him say that, he definitely does not understand, and as @Totto and @AndBreathe have said 'he is not on the plan'.

Molly if 'him indoors' does not do the insulin thing right, the testing is even more vital to get some idea of where he is...... But Molly, you can only stand and watch and listen, because I have the stomach churning feeling......that he is going to mess up and end up in hospital, and this Molly....will be the big eye opening shock,,,,and then he will start all over again, and maybe this time,,, he will listen, learn, and Understand what the insulin and the need for proper eating/medicating, and regular hours mean...and why they are so important.....

It is sad that he could not use the new injectable's/non insulin medications, they might have been a step in the right direction... before the insulin became the main treatment.....such is life and the decisions people make.....and people seem to learn by their mistakes..eventually..we hope.

Molly get the Kalms out and step back from the edge... navigating the sand dunes of indifference is going to be a big/slippy ride...... Molly posts us when you need, always here for you, from Karen.

 

[Mike d]

@Totto.... I did try to correct him and asked the question about how he would know how much insulin he needed if he didn't test .......but he doesn't listen to what I say.....which has been part of the problem all along...

Anyway, as I see it the important thing for me to do at this point in time is to make sure that he keeps that appointment next week.....and then as @Scouser58 says .....it will then be down to them to explain to him how it is going to work and what he needs to do........after that I can reinforce the message or in not so many words say "I told you so...."

The danger I feel at the moment would be that he somehow manages to cancel that appointment or refuse to attend the appointment....

@AndBreathe ....for the reasons stated above I have not asked him the questions that you suggest....though they are valid questions and ones that I have thought about....

As you rightly say "the HCPs can explain to him how it needs to be..."

..I am acutely aware of the challenges that I will face which is why I am so concerned about this move....and these will be points that I plan to raise at the appointment with a number of "what if" scenarios......his 'normal day' does not follow the conventional pattern of most other individuals in terms of sleeping / eating etc which is where I can see many problems arising in terms of moving on to an insulin regime...

..rightly or wrongly, putting him on the spot in front of someone else is I fear the only way of making him face up to this and hopefully coming to a workable solution...

Quite frankly he doesn't have a clue about this....hence his earlier comments ....and I certainly don't think he has thought of it as the route to an easy life......in fact he gives it no thought at all........he just doesn't see his diabetes to be a problem and, as my GP said to me at an appointment the other day, he is clearly suffering from "head in sand" syndrome....

I think we both know which route he is going down....they say miracles do happen......but I doubt it....

I can't believe someone could be so stupid ...... either that or in such a state of complete denial. But I do get the issue of him backing out and not wanting to confront a reality that somehow deep down I believe he knows is heading his way.

Humour him, drag him along and hopefully someone will tell him in the strongest possible terms what his options are. So annoying to "see" something like this happen when it can be turned around.

 

[AndBreathe]

......[B][U].but he doesn't listen to what I say[/U][/B].....which has been part of the problem all along........

............ ...for the reasons stated above I have not asked him the questions that you suggest....though they are valid questions and ones that I have thought about....

To be honest, if he won't listen to you, and you can't ask him any questions, I can't see what's in this whole relationship for you.

Without open and frank communication, I find it hard to call a relationship a relationship. In this scenario, I wouldn't have the man in my house, but then I'm probably just a horrible, hard, harsh old bat.